| NPI | 1730298506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MS 08343) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 08343) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-08-10 |